Neonatal respiratory distress due to congenital laryngeal cyst

: Severe, progressive, neonatal respiratory distress in a 27-month-old girl which required endotracheal intubation, was due to a congenital supraglottic saccular cyst, a rare cause. Aryepiglottic fold bulging and medial displacement of the left side of the larynx, resulting in considerable narrowing of the air-way, were prominent direct laryngoscopic findings. Transoral needle aspiration temporarily improved the infant's condition, but recurrences required repeated endotracheal intubation and needle aspiration. CT imaging demonstrated an intralaryngeal, supraglottic saccular cyst. At 2 months of age the cyst was successfully excised via a paramedian thyrotomy, and tracheotomy avoided. We suggest surgical excision of congenital saccular laryngeal cysts in infants who do not respond to repeated needle aspiration, as effective definitive treatment.